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Next Generation Pain Solutions - a Functional Neuro-Orthopedic & Low-Level Laser Therapy Approach to Pain and Injury Rehabilitation - Instructor(S): Dr

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Next Generation Pain Solutions - a Functional Neuro-Orthopedic & Low-Level Laser Therapy Approach to Pain and Injury Rehabilitation - Instructor(S): Dr Next Generation Pain Solutions - A Functional Neuro-Orthopedic & Low-Level Laser Therapy Approach to Pain and Injury Rehabilitation - Instructor(s): Dr. Trevor Berry, DC, DACNB & Dr. David George, DC, DACNB, RN, FIAMA Times: Saturday 8 am - 6:45 pm, Sunday 8:00 am – 2:15pm Total CE hours: 14 Abstract Summary: The purpose of this lecture is to present the fundamentals of an integrative neuroscience-forward clinical framework for addressing pain and musculoskeletal injury presentations. The presenters will present a rational framework for approaching painful musculoskeletal conditions that is consistent with current guidelines for pain management. Specific therapeutic modalities will be presented. These include modalities including LLLT, nutrition, topical therapies, receptor-based therapy, joint mobilization. The overall intention is to offer the clinician a solid conceptual framework for therapeutic analgesia that will allow them to better organize their clinical approach and application of therapeutic modalities. Main Objectives: Understand the integrative physical rehabilitation concept Appreciate the pathophysiology associated with neurogenic inflammation. Demonstrate an integrative approach to the treatment of neurogenic inflammation. Demonstrate an approach to the management of behavioral aspects of pain pathophysiology. Deconstructing movement efficiently and easily in order to reduce pain provocation. Demonstrate rational application of key neuromodulation technologies for pain. Take Away Concepts: (The learner will be able to) ✔ Develop a rational and efficient pain management plan based on an integrative, neuro-orthopedic and Low-Level Laser paradigm. ✔ Understanding treatment paradigms that can be used immediately. ✔ Understand outcomes assessments that demonstrate the efficacy and quality improvement of therapy that is performed based upon diagnostic direction. Key Words: (Critical components and Concepts) ✔ Pain management; integrative physical rehabilitation; physical rehabilitation; neurogenic inflammation; neuropathic pain. Targeted Clinicians: This program is designed for the following provider types: (Those with state licensure and or practice and utilization parameters of the material taught as defined within their individual scope of practice). ✔ Doctors of Chiropractic ✔ Medical Doctors ✔ Doctors of Osteopathy ✔ Naturopaths ✔ Nurse Practitioners ✔ Physician Assistants ✔ Registered Dieticians ✔ Clinical Nutritionists ✔ Acupuncturists ✔ Oriental Medicine Providers ✔ Certified Health Coaches Instructional Methods: On stage presentation Video recording Power point usage Dry erase board usage Hands on demonstrations 1 Q and A sessions Case Studies Notes available Post session testing for credit as set forth by the standards needed per hour. Summary: The information in this lecture is designed to connect the practitioner to real life topics with material and concepts that are rapidly evolving. Many components of this lecture can be coupled with overall health and wellness which is supported by appropriate laboratory testing for the aforementioned topics. Students will have notes and references to utilize as a study tool along with cases and access to instructions during session times. Program Outline: Saturday 7:30-8:00am Registration: Meet and greet and find your seat 8:00-9:45am Dr. George o Drivers of Pain and Disability: nociceptive drivers nervous system dysfunction drivers comorbidities drivers cognitive-emotional drivers contextual drivers o Pain through the Neuroscience Lens o Nociception: Movement o Neuropathic Pain: Hyperalgesia, Allodynia, Central sensitization 9:45-10:00am Break 10:00-12:00pm Dr. Berry o Introduction to Low-Level Laser Physiology o Inflammation o Central mechanisms of Inflammation o Neuropathic pain and Low-Level Laser Therapy (LLLT) o FDA Clearances and LLLT o Supporting medical necessity with FDA cleared research o Introduction to EMF and Glutamate Excitotoxicity 12:00-1:00pm Lunch 1:00-2:30pm Dr. George Pathophysiology of Neurogenic Inflammation History of treatment of nerve pain Introduction to manual techniques in superficial nerve pain Introduction to Neuro-Orthopedic applications for common pain syndromes 2:30-2:45pm Break 2 2:45-4:00pm Dr. Berry Introduction to Low-Level Laser techniques for peripheral pain conditions Introduction to Low-Level Laser techniques for central pain mechanisms Vagal nerve stimulation 4:00-4:15pm Break 4:15-6:45pm Dr. George & Dr. Berry Demonstration of manual techniques in superficial nerve pain Demonstration of low-level laser techniques in musculoskeletal conditions Demonstration of low-level laser for peripheral and central neurogenic pain conditions Introduction to multimodal application techniques for acute and chronic pain management Sunday 8:00-9:45pm Dr. Berry o LLLT research and applications for other pain related conditions o Advanced concepts for up-regulation of central pain modulators o Optimal dose for LLLT o Neurological benefits of LLLT o Hands-free laser technology 9:45-10:00am Break 10:00-12:00pm Dr. George Behavioral Modifiers of Pain o Relationship between Allodynia and Psychological variables o Neural networks associated with pain modification o Practical Approach to Behavioral modifiers of pain 12:00-1:00pm Lunch 1:00-2:15pm Dr. Berry o Case Studies o Review o Closing remarks o 15 minutes: Q and A (Dr. George & Dr. Berry) 3 References: 1. Namer, B., Schick, M., Kleggetveit, I. P., Orstavik, K., Schmidt, R., Jorum, E., … Schmelz, M. (2015). Differential sensitization of silent nociceptors to low pH stimulation by prostaglandin E2 in human volunteers. European Journal of Pain (United Kingdom), 19(2), 159–166. https://doi.org/10.1002/ejp.532 2. Shenker NG, & , Blake DR, McCabe CS, Haigh R, M. P. (2004). Symmetry , T cells and neurogenic arthritis . Novartis Found Symp., 260(241–52), 2004. 3. Kemper Talley, E. A. (2011). On the pH-optimum of activity and stability of proteins. Proteins, 78(12), 2699–2706. https://doi.org/10.1002/prot.22786.On 4. Dean, B. J. F., Franklin, S. L., & Carr, A. J. (2013). The Peripheral Neuronal Phenotype is Important in the Pathogenesis of Painful Human Tendinopathy: A Systematic Review. Clinical Orthopaedics and Related Research®, 471(9), 3036–3046. 5. Misidou, C., & Papagoras, C. (2019). Complex Regional Pain Syndrome: An update. Mediterranean Journal of Rheumatology, 30(1), 16–25. https://doi.org/10.31138/mjr.30.1.16 6. Morimoto, D., Isu, T., Kim, K., Imai, T., Yamazaki, K., Matsumoto, R., & Isobe, M. (2013). Surgical treatment of superior cluneal nerve entrapment neuropathy. Journal of Neurosurgery. Spine, 19(1), 71–75. https://doi.org/10.3171/2013.3.SPINE12420 7. Tesarz, J., Hoheisel, U., Wiedenhöfer, B., & Mense, S. (2011). Sensory innervation of the thoracolumbar fascia in rats and humans. Neuroscience, 194, 302– 308. https://doi.org/10.1016/j.neuroscience.2011.07.066 8. Pratik, D., Padhan, A., Mohapatra, S., Sarangi, S., Jyotiranjan, T., Mahapatra, A., & Kundu, A. (2018). Mechanisms of Neuropathic Pain. International Journal of Livestock Research, 8(5), 50. https://doi.org/10.5455/ijlr.20171128040037 9. Matsuda M, Huh Y, R.-R. J. (2019). Roles of Inflammation, Neurogenic inflammation, and Neuroinflammation in Pain. J Anesth, 33(1), 131–139. https://doi.org/10.1016/j.physbeh.2017.03.040 10. Gouin, O., L’Herondelle, K., Lebonvallet, N., Le Gall-Ianotto, C., Sakka, M., Buhé, V., … Le Garrec, R. (2017). TRPV1 and TRPA1 in cutaneous neurogenic and chronic inflammation: pro-inflammatory response induced by their activation and their sensitization. Protein and Cell, 8(9), 644–661. https://doi.org/10.1007/s13238-017-0395-5 4 .
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